• Hospitalized patients with euvolemic or hypervolemic hyponatremia.

Contraindicated in:

• Hypersensitivity
• Hypovolemic hyponatremia
• Concurrent use of ketonconazole, itraconazole, clarithromycin, or ritonavir
• Lactation: Lactation.

Use Cautiously in:

• Moderate or severe hepatic impairment (↓ dose recommended)
• Severe renal impairment (not recommended if CCr <30 mL/min)
• OB: Safety not established in pregnancy
• Pedi: Safety and effectiveness not established in children.

CV: hypertension, hypotension.

F and E: dehydration, hypokalemia, hypomagnesemia, hyponatremia, thirst.

GI: diarrhea.

GU: ↓ fertility (females), polyuria.

Neuro: headache, confusion, insomnia.
Misc: infusion reactions, fever.

Drug-Drug:

• CYP3A4 inhibitors, including ketoconazole, itraconazole, clarithromycin, and ritonavir, may ↑ levels and risk of toxicity; concurrent use contraindicated.
• May ↑ levels and risk of toxicity of CYP3A4 substrates, including midazolam, simvastatin, lovastatin, and amlodipine; careful monitoring recommended.
• May ↑ digoxin levels and risk of toxicity.

• Premixed infusion: 20 mg/100 mL D5W;

• IV (Adults): 20 mg loading dose initially, followed by 20 mg/day as a continuous infusion for 2–4 days. May titrate conivaptan up to 40 mg/day as a continuous infusion if serum sodium is not rising at desired rate. Total duration of therapy should not exceed 4 days.

Vaprisol

• Antagonizes vasopressin at V₂ receptor sites in renal collecting ducts, resulting in excretion of free water.

• Increased serum sodium concentrations.
• Improved fluid status.

Therapeutic Classification: electrolyte modifiers

Pharmacologic Classification: vasopressin antagonists

Absorption: IV administration results in complete bioavailability.

Distribution: Unknown.

Protein Binding: 99%.

Metabolism/Excretion: Primarily metabolized by the liver via the CYP3A4 isoenzyme. 83% excreted in feces as metabolites, 12% in urine (as metabolites).

Half-life: 5 hr.

(plasma concentrations)

• Explain purpose of medication to patient.
• Instruct patient to notify health care professional if pain or redness occurs at infusion site.
• Advise females of reproductive potential to notify health care professional if pregnancy is planned or suspected or if breastfeeding.

con-i-VAP-tan